Corneal impression test for the diagnosis of acute rabies encephalitis.
OBJECTIVE
This study aimed to alert ophthalmologists as to their role in the diagnosis of rabies.


METHODS
A 13-year-old girl was admitted with acute encephalitis of unknown etiology. Bacterial and viral cultures and test results for Lyme disease and tuberculosis were negative. Initial cerebrospinal fluid, serum, skin, and saliva specimens were negative for rabies. A corneal impression test was performed.


RESULTS
Immunofluorescent antibody staining of the epithelial cells on the corneal impression test was positive for rabies. Subsequently, the diagnosis was confirmed by serum serologic analysis and saliva testing.


CONCLUSIONS
Ophthalmologists can assist in the diagnosis of rabies by using the corneal impression test. Corneal smears should be part of the routine antemortem work-up for presumptive rabies.
Zaidman
G W
GW
New York Medical College, Westchester County Medical Center, Valhalla 10595, USA.
Billingsley
A
A
D000208:Acute Disease; D000293:Adolescent; D000914:Antibodies, Viral; D000956:Antigens, Viral / Q000032:analysis; D003316:Corneal Diseases / Q000175:diagnosis* / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D003941:Diagnostic Techniques, Ophthalmological; D018792:Encephalitis, Viral / Q000175:diagnosis* / Q000209:etiology; D019573:Epithelium, Corneal / Q000821:virology*; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000821:virology; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D016133:Polymerase Chain Reaction; D011818:Rabies / Q000175:diagnosis* / Q000209:etiology; D011820:Rabies virus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification*; D012463:Saliva / Q000821:virology
D000914:Antibodies, Viral; D000956:Antigens, Viral; D004279:DNA, Viral